Search For Best Practices Research Articles

Port environmental efficiency assessment using the one-stage and two-stage model DEA: comparison of Koper and Dublin ports

Ports are important and central hubs for logistical activities in transportation chains that contribute to economic growth. Nevertheless, port activities are associated with undesirable impacts such as energy consumption and air pollutant emissions. Various policy instruments and measures have been developed and adopted to reduce energy consumption and emissions from ports. In an effort to manage all undesirable impacts of port operations, the search for best practices has proven to be an effective approach. This study examines one- and two-stage Data Envelopment Analysis (DEA) models for measuring port environmental efficiency. The adequacy of the models was analyzed using two case studies, i.e., the port of Koper and port of Dublin. The results of the study provided the best practices and the main differences between one-stage and two-stage models. Distance metrics were used to identify the necessary improvements of inefficient decision-making units (DMUs) to achieve the best practices.

The challenges of data safety monitoring for a pragmatic study: Lessons from the ADAPTABLE study

Data monitoring committees (DMCs) play a critical role in protecting the safety of participants and integrity of clinical studies. While there are well-established DMC guidelines for traditional, randomized controlled trials, the clinical trial community is still in the search for best practices in data and safety monitoring in pragmatic clinical trials. ADAPTABLE was a large, open label, pragmatic, randomized controlled trial, harnessing real world data from multiple sources and studying the comparative effectiveness of the two most common dosages of aspirin in patients with atherosclerotic cardiovascular disease. Specific issues arose in ADAPTABLE such as data quality, information latency, and protocol adherence, and these issues were both expected and unexpected features of the pragmatic study design. These issues imposed great challenges to the DMC members who were tasked to make critical decisions during the study. This article summarizes the unique experience of the ADAPTABLE DMC, including the internal debates and concerns, the concerted efforts to accomplish its mission, and the special contribution of the patient representatives. We also offer recommendations on data and safety monitoring for future pragmatic trials.

Logistics Efficiency of APEC Economies: Diagnosis, Interconnections and Digital Experience for Russia

The Asia-Pacific Cooperation Forum is one of the largest regional economic organizations. APEC unites the economies of several parts of the world with very different levels of economic development. The functioning of transport and logistics systems should be focused on minimizing the problem areas which cause difficulties with the reliability, timeliness, transportation efficiency. Transportation is one of the key issues in APEC, and they are included in the agenda and discussed at meetings of the Transportation Working Group. Considering the degree of uneven economic development within APEC and the need to eliminate it, the assessment of logistics efficiency as a factor of this development and the search for best practices to improve it is one of the urgent scientific tasks.

Зарубежный опыт администрирования НДС

The purpose of the article is to study foreign experience in VAT administration. Research methodology - objectivism, historicism and analysis. The VAT system has been used by the EU for a relatively long time, which makes it possible to judge the effectiveness of its use. The variety of VAT benefits and rates makes it difficult to administer. Search for best practice in VAT administration is needed. Countries with a traditional VAT system are experiencing difficulties. Therefore, it is necessary to search for new forms. Avoiding multiple rates and perks is advantageous. The use of new information technologies makes relations between business and the state transparent. In the future, the VAT will change and possibly become a sales tax. This will require the development of new requirements for persons working with VAT.

Placental magnetic resonance imaging: normal appearance, anatomical variations, and pathological findings.

Placental magnetic resonance imaging (MRI) has been increasingly requested, especially for the evaluation of suspected cases of placental adhesive disorders, generally known as placenta accreta. Abdominal radiologists need to become familiar with normal placental anatomy, anatomical variations, the current terminology, and major placental diseases that, although rare, are important causes of maternal and fetal morbidity and mortality. The aim of this didactic pictorial essay is to illustrate various findings on placental MRI, as well as to emphasize the importance of communication between radiologists and obstetricians in the search for best practices in the management of the affected patients.

ENGAGEMENT MARKERS IN THE FEYNMAN LECTURES ON PHYSICS: APPLYING HYLAND’S INTERACTION FRAMEWORK TO SPOKEN ACADEMIC DISCOURSE

The paper presents an analysis of engagement markers in the Lectures on Physics by eminent scientist and Nobel prizewinner R. P. Feynman, based on K. Hyland’s model of interaction in academic discourse as stance and engagement. The Lectures were taught at the California Institute of Technology during 1961-63 and, having been turned into a textbook, are widely used by Physics students even today. It is argued that the Lectures owe their lasting popularity not only to the simplicity of explication, but also to Feynman’s masterful use of interaction devices, particularly reader pronouns, directives, questions, references to sharedness and personal asides. Reader pronouns are analysed in comparison with the MICASE-based reference corpus, with the most common you- and we-clusters being identified. It is established that reader pronouns, directives and questions in the Feynman’s Lectures on Physics mostly perform the functions of anticipating possible objections, eliciting prior knowledge, focusing students’ attention, stimulating their thought and creativity, while references to sharedness and personal asides serve to strengthen the lecturer’s communality with the audience, particularly through the use of humour. We draw the conclusion that Hyland’s taxonomy of engagement markers can be applied to spoken academic discourse in its entirety and can be particularly useful for the description of interactive styles of acknowledged scientists, supplementing depersonaliased corpus research in search for best practices in pedagogy.

Deliberative participatory budgeting: A case study of Zeguo Town in China

SummaryThe search for a better practice instrument of civic engagement has led to participatory budgeting and deliberative polling in recent years. Participatory budgeting stresses empowerment and citizens' struggle against the establishment and unequal social structures, whereas deliberative polling works within the system and focuses on improving democratic decision‐making processes by applying credible social science methods. Often, these two processes are presented as being in conflict with each other, which is to the detriment of the search for best practice in deliberative governance. This paper develops a theoretical analysis of deliberative participatory budgeting which is distinguished from unrepresentative and non‐deliberative but self‐selected participatory budgeting; that is, it considers how the quality of participatory budgeting can be improved through deliberative polling. This theoretical analysis is backed by an empirical study of deliberative participatory budgeting in Zeguo Township, Zhejiang Province, China. It explores whether, how, and under what conditions it is possible to combine deliberative polling and participatory budgeting. It details four experiments and assesses the successes, failures, limitations, and problems of the experiments. The case of Zeguo offers scholars, activists, and officials lessons about how to pursue best deliberative practice in both authoritarian states and democratic societies.

Action research improves services for child sexual abuse in one Caribbean nation: An example of good practice.

Child sexual abuse (CSA) is a multi-dimensional problem. The search for best practice must consider the complexities surrounding CSA and its management in any particular society. Data previously gathered from service providers on CSA service provision in Trinidad and Tobago identified key deficient issues in policy and practice. In this paper, researchers aimed to bridge the gaps identified, and effect changes to improve services for CSA using an action research methodology. Service providers from all sectors in governmental and non-governmental organizations in Trinidad and Tobago, who work with children at risk of CSA were involved in the process. Researchers led the service providers into an awareness of their own practice through critical discussion of, and reflection on, the key deficient issues. The new knowledge generated, with guided input from evidenced-based best practice, led to the development of guidelines for management. Discussion of the practicability of the guidelines by service providers in multiple sectors generated more new knowledge that refined the management approach. The contextual knowledge obtained from service providers resulted in best practice guidelines for service providers that were culturally relevant and context-sensitive, adaptive and implementable, and allowed a seamless multidisciplinary response to CSA in Trinidad and Tobago within prevailing constraints. Action research offers an effective approach to improve services for CSA through mobilization of service providers and changes in policy and practice. It is applicable in any setting and likely to be effective in any socio-cultural context.

Klebsiella oxytoca Multiresistant as an Agent of Disseminated Dermatitis in a Dog

Background: During the last years, there is a global concern about the increasing levels of antimicrobial resistance in human and veterinary medicine. Klebsiella oxytoca isolates are ubiquitous in nature, including surface water, soils, sewage, and plants. Klebsiella oxytoca is a nosocomial pathogen in humans but few studies reported as a pathogen in dogs and cats. Antimicrobial resistance represents a serious problem due to the increasing prevalence of extended-spectrum β-lactamaseproducing K. oxytoca isolates. The aim of the present study is describe the first clinical case of disseminated dermatitis in a dog caused by K. oxytoca multidrug resistant and the importance of correct protocol treatment.Case: A 4 year-old dog, Shih-tzu, female showed a disseminated dermatitis displayed generalized alopecia, with seborrheic aspect and pruritus, in non-nosocomial conditions in the city of São Paulo. Skin samples were collected and sent to a veterinary microbiology laboratory for bacterial identification and antimicrobial susceptibility testing (AST). The tests demonstrated a Gram negative bacilli, oxidase negative, catalase positive, non motile, DNase negative, glicose fermentative, lactose positive in MacConkey agar. In all biochemical complementary tests the results were indole positive. The strain of K. oxytoca was tested for resistance to the following antibiotics: amikacin, amoxicillin-clavulanic acid, ampicillin, cephalexin, cephalosporin, chloramphenicol, ciprofloxacin, doxycycline, enrofloxacin, gentamicin, imipenem, levofloxacin, marbofloxacin, meropenem, neomycin, sulfamethoxazole/trimethoprim and tetracycline. The AST result demonstrated a resistant Klebsiella oxytoca for 76,4% of tested antibiotics and sensitivity to few antibiotics such as meropenem, imipenem, neomycin, amikacin, sulfamethoxazole and trimethoprim. The initial treatment was performed with meropenem, once the in vitro susceptibility to this antibiotic was demonstrated. However, resistance was observed at 6 days of treatment at a dose of 24 mg/kg /day. After the protocol was changed up to 40 mg/kg/day and maintenance of the dose of 30 mg/kg/day in combination with amikacin (20 mg/kg/day) by continuous administration, the dog had complete remission of symptoms.Discussion: As in human medicine, some microorganisms are becoming multiresistant and emerging pathogens, such as K. oxytoca will be a major challenge for veterinarians, because while at the same time committed to the judicious use of antibiotics, antimicrobial resistance can make infections difficult to treat. The hospitalization of the animal was fundamental for the therapeutic success in the adjustment of doses and the monitoring of the clinical conditions, with remission of the symptoms after 23 days of associated amikacin and meropenem therapy. The cases of K. oxytoca are few discussed or unknown in the routine of veterinary medicine. This scenario should be analyzed in the search for best practices and treatment protocols based on the susceptibility profile of the pathogen. This means prescribing the right antibiotic in the appropriate dose for the target microorganism. Pet owners can help prevent antimicrobial resistance by supporting their veterinarian’s decision to perform tests such as bacterial culture and sensitivity testing as well as hospitalization of the animal for treatment under biosecurity conditions as an important decision-making to avoid cross-contamination between animals and owners, since K. oxytoca is of great importance in animal and human public health.

Pregnant Genetic Counselors in an Era of Advanced Genomic Tests: What Do the Experts Test Prenatally?

Advanced genomic tests in pregnancy, such as chromosomal microarray analysis (CMA), provide higher detection rates yet often produce probabilistic and uncertain information. This study aimed to understand how the most knowledgeable patients, i.e., pregnant genetic counselors, act in their own pregnancies, thereby gaining insight into the impact of patients' knowledge on the diagnostic process. Seventeen interviews were conducted with Israeli genetic counselors, either pregnant or up to 2years post-pregnancy. A third of the participants chose not to have CMA while two thirds underwent it despite no detected abnormalities. Although knowledge was the main motivation, counselors varied in the desired degree of information. Two thirds of those opting for CMA wished to have all findings identified whereas roughly one third asked for a targeted platform seeking to avoid uncertain results. Counselors were not quick to adopt new tests such as whole-exome sequencing. Being knowledgeable was described as promoting a sense of control yet also being a source of stress and moral dilemmas. While the basic premise of informed consent is crucial, it does not always make things easier for educated patients. Consequently, raising levels of patient knowledge is only a limited step forward in the search for best practice.

Nonsuicidal Self-Injury, Interpersonal Neurobiology, and Attachment: Implications for Counselors and Therapists

Given its prevalence, nonsuicidal self-injury (NSSI) is increasingly becoming the focus of mental health counselors and other clinicians. Even when these individuals are knowledgeable about NSSI, the best treatment approaches remain uncertain. While several therapeutic treatments have been evaluated for their effectiveness, results are inconclusive. As the search for best practice continues, the authors propose attachment theory and interpersonal neurobiology as relevant to NSSI, especially considering their potential to facilitate emotion regulation. A case example is provided.

Presentation Number 15 - Colon Surgery: Dirty Business of Surgical Site Infections

BACKGROUND: Colon surgery is known to be a dirty surgery among surgeons.This session discusses the battle of safety culture against difficult patient’s circumstances such as ruptured bowel. The process of social change starts with awareness of high SSI in colon surgeries followed by denial from the surgeons to their rate and National SIR that takes in account the risk of surgery, the wound class, patient comorbidities, etc. The acceptance stage is the most powerful aspect of this project because it motivated the surgeons to find a common ground where all their search for best practices was placed into one bundle. METHODS: The Colon Bundle includes three stages. Preoperative stage included skin prep., prophylactic oral and IV antibiotics, bowel prep, and patient education. Intra-operative stage included limited OR traffic, maintaining patient’s normothermia during the case, use of wound closer protector device, changing gown and gloves prior to closure, and close monitor to patient glucose level. Post-operative stage included dressing change within 48 hours of surgery, continue IV antibiotic, and patient and family education. RESULTS: The results of the implementation of the colon bundle led to the reduction of colon SSI. In 2014, the total cases of colon SSI were 19 cases, as of today the total cases of colon SSI in 2015 are 5 cases. The highest SIR was in Q2 of 2014 was 2.1 which was reduced to a SIR of 0.0 in Q2 of 2015. CONCLUSIONS: The main concept of project was not really the reduction is the science behind the detection of increase in the colon SSI trend, the struggle to persuade the surgeons of the increase in the SSI rate of SIR, and finally, the ability of the team to come together to implement a successful program for the benefit of quality care that directly impact the safety of our patients. Presentation Number 16 Suspected Origins of Bacteremia in Center for Disease Control (CDC) National Healthcare Safety Network (NHSN) Defined Central Line Associated Bloodstream Infections (CLABSI) at a Tertiary Care Academic Medical Center

The Developing Relationship Among Cognition, Amplification, and Aural Rehabilitation

The search for best practices in hearing aid fittings and aural rehabilitation has generally used the audiogram and function stemming from peripheral sensitivity. In recent years, however, we have learned that individuals respond differently to various hearing aid and aural rehabilitation techniques based on cognitive abilities. In this paper, we review basic concepts of working memory and the literature driving our knowledge in newer concepts of hearing aid fitting and aural rehabilitation.

The Developing Relationship Among Cognition, Amplification, and Aural Rehabilitation

The search for best practices in hearing aid fittings and aural rehabilitation has generally used the audiogram and function stemming from peripheral sensitivity. In recent years, however, we have ...

Trastuzumab Rechallenge After Lapatinib- and Trastuzumab-Resistant Disease Progression in HER2-Positive Breast Cancer

BackgroundMultiple anti-HER2 therapies have improved the outcome for patients with HER2-positive breast cancer. However, optimal management has yet to be established for lapatinib (LAP)- and trastuzumab (Tmab)-resistant disease progression. Data from our institution were reviewed to contribute to the search for best practices. Patients and MethodsBetween June 2009 and March 2013, 74 HER2-positive advanced breast cancer (ABC) patients were treated with LAP with capecitabine (LAPCAP). Patients re-treated with Tmab-based chemotherapies were identified, with a focus on baseline characteristics, chemotherapies, and efficacy. The study focused on the clinical outcomes of 50 patients re-treated with Tmab after LAPCAP-resistant disease progression (LAPCAP-PD), with an assessment of tumor response and clinical benefit (CB). Progression-free survival (PFS) was used as a predictive surrogate marker for the efficacy of Tmab rechallenge. ResultsAll patients were pretreated with Tmab- and LAP-based chemotherapies. At a median follow-up of 7.9 months, PFS was 4.6 months, and overall survival was 33.7 months after LAPCAP-PD. Rechallenges with Tmab-based chemotherapies included gemcitabine (GEM) in 23 patients, vinorelbine in 14, taxanes in 5, endocrine treatments in 2, and others. The CB rate was 32%, including complete response for 1, partial response for 3, and > 6 months of stable disease for 12. Although the median PFS was longer for patients treated with microtubule inhibitors (MTIs) than with GEM, various chemotherapies had different efficacy regardless of whether or not previous LAPCAP had CBs. ConclusionTmab rechallenge combined with not only MTIs but also an antimetabolite agent is effective against some LAPCAP-PD HER2-positive ABC.

Search for Best Practice on Postpartum Maternal Accompaniment on Transport

Search for Best Practice on Postpartum Maternal Accompaniment on Transport

Integrating human factors and prevention systems to improve safe operations and performance

The high-risk nature of the oil and gas industry means the search for best practices to ensure employees suffer no harm is ongoing. Our industry has undergone multiple-step changes in safety, including the eras of death, engineering, regulations, and, more recently, behaviours. The unifying aspect to expand the results achieved from these step changes is the seamless merging of human factors and prevention systems, which are explored in further detail in this extended abstract. Human factors are how individuals behave physically and psychologically to their work environment. Prevention systems are the equipment, systems, and processes the organisation provides and implements to keep individuals safe in the work environment. The manner in which human factors and prevention systems collaborate delineates Intertek's processes in safety. To better understand both human factors and prevention systems, the authors analysed their sub-components, ultimately making their use more relevant for the needs of this industry. A consistent understanding of each subsequently allows better identification of where the gaps may exist and allows focus on processes for not only improved business results but also achievement of no harm to employees. Although this extended abstract primarily concentrates on human factors, a means of assessing employees' abilities to behave in their work environment alongside an organisation's prevention systems is also discussed.

Performance measurement and the search for best practices

Current performance measurement methods are a-contextual and unable to measure the effectiveness of policies. They usually result in rankings that measure the extent of the policy problem, but they fail to reveal anything substantive about the quality of policies, and they are equally unhelpful in the search for best practices. The goal of this article is to further develop and validate a mixed method of performance measurement — a combination of statistical analysis, residue analysis and case study approach — which considers the policy context, relates the outcomes to the policies, and provides guidance in the systematic search for best practices. In this article, this approach will be tested against one of the problems mentioned in the Millennium Development Goals, e.g. literacy rates. Points for practitioners Many practitioners struggle with the question how to determine whether their performance is above or below expectations. Classic performance measures can give a distorted view on this question. Using the method introduced in this article might give a better picture of the robustness and effectiveness of performance than the traditional performance measures. It adapts to the adversity of the context and circumstances in which policies come about.

The ongoing search for best practice in clinical teaching and learning: A model of nursing students’ evolution to proficient novice registered nurses

This article describes the development of a model of nursing students as evolving registered nurses (RNs). It aims to generate critical debate about innovations in nursing teaching and learning. The model is the outcome of research conducted with undergraduate nursing students (n=111) from Flinders University, Adelaide, South Australia. It identifies the positive and negative intrinsic and extrinsic factors that impact on nursing students' clinical learning development and progression from students to proficient novice RNs. This model has implications for future curriculum development, staff development, placement approaches and research in relation to clinical teaching and learning.

HRM Effectiveness in Older People's and Nursing Homes: The Search for Best (Quality) Practices

This article presents an empirical evaluation of the human resources management (HRM) effectiveness in relation to quality of labor and quality of care in older people's and nursing homes. The authors suggest that innovative policies, in terms of HRM and work design, increase the likelihood of lower stress rates and higher scores on quality of care. The data supply little empirical evidence for this hypothesis, which means that innovative policy practices have very little effect on the realities of stress, burnout, and individually tailored care. A question that arises from this is whether the search for best practices is then equal to a measure for nothing. This is not the authors' opinion. The reference framework for research must be turned round. This can be achieved by no longer starting from the normative (practice) theory but starting instead with excellent practice, which can teach researchers important content and policy lessons.